The public health challenge of air
pollution – a WHO perspective
Dr Dorota Jarosinska
WHO European Centre for Environment and Health
Solutions Initiative Forum - Air
28 August 2019, Gothenburg, Sweden
WHO role - putting the health argument at
the forefront of policy making and actions
• Consolidation of scientific evidence
• Methods and tools to support decision making
• Strengthening capacities in Member States
• Facilitating intersectorial and multistakeholder action
• Advocacy
Air quality and health - WHO milestones 1958
1964
1972
(1976-84)
1987
2000
2005
2009
2010
2014
2015 - WHA Resolution 68.8
2018 - First Global Conference on AQ and Health
WHO technical reports
Update
Since 2016…
Health effects of air pollution - summary of
evidence for action
• Evidence on health effects of air pollution has grown gradually over the last six decades
• Epidemiological studies from 1990s identified effects of low (common in urban environment) concentrations of “classical” air pollutants (PM, NO2, SO2 and ozone)
• Growing understanding of causal pathways of health effects of “classical air pollutants” in the last 10-15 years
• Estimation of global burden of disease due to air pollution in the last years
Exposure to air pollution in 2016
91% of world population breathe the air above the WHO Air Quality Guidelines values …
… if achieved, are expected to result in significantly reduced rates of adverse health effects
WHO ambient air quality database
In 2018, more than 4300 cities in 108 countries
www.who.int/airpollution/data/cities
Public health impact of air pollutionGlobally
7 million premature deaths per year
4.2 million due to ambient air pollution
3.8 million due to household air pollution
WHO European Region
550 000 premature deaths per year
509 000 due to ambient air pollution
56 000 due to household air pollution
Air pollution and NCDs -
focus on cardiovascular diseases
24% 25%
WHO AQG 2006
Pyramid of health effects due to air pollution
ERS/ISEE 2019
Air pollution affects many organs and systems
https://www.who.int/ncds/governance/third-un-meeting/brochure.pdf?ua=1
• ‘Best buys’ for air pollution
• Economic assessments
• WHO European High-level Conference on NCDs: Time to deliver – meeting NCD targets to achieve Sustainable Development Goals in Europe
WHO action on air pollution and NCDs
http://www.euro.who.int/en/health-topics/environment-and-health/air-quality/publications/2019/noncommunicable-diseases-and-air-pollution-2019
Tackling air pollution to protect human health
• Multi-sectorial
• Multi-stakeholder
• Multi-level
• Multiple settings
• Multiple time frames
• Multiple benefits
First WHA Resolution on Air Pollution and
Health (WHA 68.8, May 2015)• Highlights the key role of health authorities in raising awareness about the potential
to save lives and reduce health costs, if air pollution is addressed effectively
• Identifies the need for strong cooperation between sectors and integration of health concerns into all national, regional and local air pollution-related policies
• Urges Member States to develop air quality monitoring systems and health registries to improve surveillance for all illnesses related to air pollution
• Urges Member States to strengthen international transfer of … technologies and scientific data in the field of air pollution
• Recognizes the role of WHO AQG …in providing recommendations for clean air that protect human health
http://apps.who.int/gb/or/e/e_wha68r1.html
European Environment and Health Process
The Ostrava Declaration (2017)Improve indoor and outdoor air quality
Ensure access to safe drinking-water, sanitation and hygiene
Minimize adverse effects of chemicals
Strengthen adaptation to and mitigation of climate change
Prevent adverse effects of waste mgmt. & contaminated sites
Support cities and regions to become healthier
Build the environmental sustainability of health systems
Ministerial Declaration
Compendium of possible actions
Institutional arrangements
http://www.euro.who.int/en/media-centre/events/events/2017/06/sixth-ministerial-conference-on-environment-and-health
WHO global strategy on health, environment
and climate change (May 2019)
A vision on how to respond to environmental health risks and challenges until 2030 and ensure safe, enabling and equitable environments for health by transforming way of living, working, producing, consuming and governing
Key settings as sites for interventions
… to address environmental health risks and reduce health inequalities, while responding to demographic, social, economic, technological and lifestyle changes
… households, schools, workplaces, health care facilities, cities….
http://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_15-en.pdf
WHO is custodian of the air pollution-related
SDGsAir quality in cities
Clean energy access
Mortality from air pollution
SDG 11.6.2: Annual urban mean concentration of particulate matter (PM2.5), population-weighted
SDG 7.1.2: Percentage of population with primary reliance on clean fuels and technologies at the household level
SDG 3.9.1: Mortality from air pollution
Tools and methods: AirQ+
For calculating estimates
that support decision-makers
to develop appropriate actions
to protect public health
WHO software to calculate the health impacts of air pollution
http://www.euro.who.int/en/health-topics/environment-and-health/air-quality/activities/airq-software-tool-for-health-risk-assessment-of-air-pollution
Other tools and methods
Achieving health benefits from carbon reductions - CaRBonH tool
Health Economic Assessment Tool (HEAT) for walking and cycling
http://www.euro.who.int/en/health-topics/environment-and-health/Climate-change/publications/2018/achieving-health-benefits-from-carbon-reductions-manual-for-carbonh-calculation-tool-2018
http://www.euro.who.int/en/health-topics/environment-and-health/Transport-and-health/activities/guidance-and-tools/health-economic-assessment-tool-heat-for-cycling-and-walking
Regional and global platforms
• TFH - the Joint WHO/UNECE Long-range Transboundary Air Pollution (LRTAP) Convention Task Force on Health Aspects of Air Pollution
• The Global Platform on Air Quality and Health - to strengthen countries capacity to address air pollution and related health risks
• Global Energy and Health Platform – to accelerate the transition to clean energy to improve health and livelihoods
http://www.euro.who.int/en/health-topics/environment-and-health/air-quality/activities/health-aspects-of-long-range-transboundary-air-pollution
30 October – 1 November 2018, Geneva, Switzerland
Clean Air for All: Geneva Action Agenda
www.who.int/airpollution/events/conference/en/
• Implement solutions to burn less in any form – reduce open burning, fuel burning in transport, cooking, heating and other processes
• Strengthen action to protect the most vulnerable, in particular children
• Enhance education: children, medical professions, patients, general population
• Strengthen Universal Health Coverage to implement actions to prevent air pollution
• Monitor, not only air pollution, but also actions and progress made
• Continue building the evidence, in particular on cost-effective solutions
• Build key partnerships for shared global response and efficient local action
Clean Air. Healthy
Future.A global campaign to protect our health and climate by improving air quality
55 cities, regions or countries have joined the network, committing to bring air
quality to safe levels by 2030—impacting 153 million citizens
Thank you for your attention
http://www.euro.who.int/en/health-topics/environment-and-health